Provider Demographics
NPI:1609279041
Name:STINCHCOMB, ERIKA MICHELLE (ATC)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MICHELLE
Last Name:STINCHCOMB
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3RD AVENUE WEST
Mailing Address - Street 2:17
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119
Mailing Address - Country:US
Mailing Address - Phone:760-420-2398
Mailing Address - Fax:
Practice Address - Street 1:3003 W CASINO RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-1910
Practice Address - Country:US
Practice Address - Phone:425-266-1976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT28072146N00000X
MT10112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic